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GPs to get quality reward payments a year early

A further carrot has been

offered to entice GPs to vote Yes to the new contract with a promise to bring quality and outcomes reward payments forward by a year.

GPs claim the preparatory and aspiration payments are not enough to tide them over in the first year of the quality framework and practices were concerned about running up huge debts.

Dr Hamish Meldrum, joint-deputy GPC chair, said he appreciated the problems with cashflow and hoped to bring a 'significant' amount of the reward money forward from 2005/6 into 2004.

He said: 'We are discussing this with the NHS Confederation and think we can bring a significant amount of the reward money forward into 2003/4.'

Annual quality preparation payments averaging £3,000 per GP are due to be paid for three years from next month.

GPs were supposed to get a third of the total value of points in advance as monthly aspiration payments spread over the year. Under the new deal, a much bigger proportion of the money would be paid up front.

Dr Meldrum warned that practices that failed to achieve their points target would face a clawback of aspiration money the following year. 'The snag is if you don't make it, you will have been overpaid and it would go down the next year,' he said.

Dr Penny Flaxman, a GP in Lutterworth, Leicestershire, said paying a third of the cash as aspiration fees was inadequate. She told a contract roadshow in Leicester last week: 'If the average GP achieves the full 1,050 points, they will be owed over £15,000 at the end of the year. You can't run a business like that. It doesn't seem feasible.'

Dr Meldrum said a decision still had to be taken on how the £75 average value per quality point would be weighted to account for practice size in the case of GPs that opt to abandon the Carr-Hill formula in favour of the renegotiated deal.

He said weighting could be based on a practice's registered patient population, or on their Carr-Hill weighting.

Could your practice cope with the lag in quality payments?

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